Welcome

Menu

Services

Denial Management Specialist

Overview

The Denial Management Specialist works a part of a central billing office team to
process insurance payments and ensure that denied claims are worked in a timely
manner to ensure payment. The Denial Management Specialist will accurately enter
insurance payments as well as working denied and/or rejected claims.

Responsibilities

Primary Accountabilities

  • Helps ensure timely and complete follow up on unpaid or denied claims.
  • Help ensure complete and accurate posting of all payer payments.
  • Timely submit issues that caused unpaid claims are resubmitted in a timely fashion based upon industry standards.
  • Review complex denials and refund requests, dispute or appeal as necessary
  • Contact vendors regarding denials or benefit changes.
  • Complete complex tasks relating to insurance verification, resolution of aging accounts, resolution of patient complaints, and client customer service
  • Research, identify and facilitate resolution to complex problems with overdue or unpaid accounts.
  • Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization.
  • Answer and resolve telephone inquiries from internal and external sources.
  • Perform other duties as assigned.

Knowledge/Skills/Abilities

  • High level of skill at building relationships and providing excellent customer service.
  • Ability to utilize computers for data entry, research and information retrieval.
  • Strong attention to detail and accuracy.
  • Ability to understand complex insurance issues, including assigning correct payer, adjustments and refunds to accounts.
  • Must have, time management, organizational, data processing and analytical skills with proficiency in Excel and Microsoft Office Suite as well as medical practice management software and electronic medical records.
  • Ability to multi-task.
  • Excellent verbal and written communication skills.
  • Must be able to effectively monitor steps in claims processing operations.
  • Must have highly developed problem-solving skills
  • Through leadership and by example, ensures that services are provided in accordance with state and federal regulations, organizational policy, and accreditation/compliance requirements.
  • Executes excellent customer service and professionalism when interacting with staff, payers, patients and families to ensure all are treated with kindness and respect.
  • Promptly identify issues and reports them to their direct supervisor.
  • Maintain regular and predictable attendance.

Qualifications

High school diploma or GED

  • 2 years working in a medical billing role.
  • 2 years medical billing and collections experience.
  • Advanced knowledge of medical terminology, ICD 10, CPT, HCPCS coding and HIPAA requirements.
  • Extensive knowledge and experience with commercial, government and state billing and reimbursement procedures.
  • Demonstrated proficiency in the use of computer and commonly used software, including electronic medical records (EMR).

Denial Management Specialist

Overview

The Denial Management Specialist works a part of a central billing office team to
process insurance payments and ensure that denied claims are worked in a timely
manner to ensure payment. The Denial Management Specialist will accurately enter
insurance payments as well as working denied and/or rejected claims.

Responsibilities

Primary Accountabilities

  • Helps ensure timely and complete follow up on unpaid or denied claims.
  • Help ensure complete and accurate posting of all payer payments.
  • Timely submit issues that caused unpaid claims are resubmitted in a timely fashion based upon industry standards.
  • Review complex denials and refund requests, dispute or appeal as necessary
  • Contact vendors regarding denials or benefit changes.
  • Complete complex tasks relating to insurance verification, resolution of aging accounts, resolution of patient complaints, and client customer service
  • Research, identify and facilitate resolution to complex problems with overdue or unpaid accounts.
  • Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization.
  • Answer and resolve telephone inquiries from internal and external sources.
  • Perform other duties as assigned.

Knowledge/Skills/Abilities

  • High level of skill at building relationships and providing excellent customer service.
  • Ability to utilize computers for data entry, research and information retrieval.
  • Strong attention to detail and accuracy.
  • Ability to understand complex insurance issues, including assigning correct payer, adjustments and refunds to accounts.
  • Must have, time management, organizational, data processing and analytical skills with proficiency in Excel and Microsoft Office Suite as well as medical practice management software and electronic medical records.
  • Ability to multi-task.
  • Excellent verbal and written communication skills.
  • Must be able to effectively monitor steps in claims processing operations.
  • Must have highly developed problem-solving skills
  • Through leadership and by example, ensures that services are provided in accordance with state and federal regulations, organizational policy, and accreditation/compliance requirements.
  • Executes excellent customer service and professionalism when interacting with staff, payers, patients and families to ensure all are treated with kindness and respect.
  • Promptly identify issues and reports them to their direct supervisor.
  • Maintain regular and predictable attendance.

Qualifications

High school diploma or GED

  • 2 years working in a medical billing role.
  • 2 years medical billing and collections experience.
  • Advanced knowledge of medical terminology, ICD 10, CPT, HCPCS coding and HIPAA requirements.
  • Extensive knowledge and experience with commercial, government and state billing and reimbursement procedures.
  • Demonstrated proficiency in the use of computer and commonly used software, including electronic medical records (EMR).

Medical Assistant

Duties and Responsibilities:

  • Helps patients by providing information, services, and assistance.
  • Verifies patient information by interviewing patients, recording medical history, and confirming purpose of visit.
  • Saves doctors’ time by helping with office procedures.
  • Secures patient information and maintains patient confidence by completing and safeguarding medical records; completing diagnostic coding and procedure coding; and keeping patient information confidential.
  • Counsels patients by transmitting physician’s orders and questions about surgery.
  • Maintains safe, secure, and healthy work environment by establishing and following standards and procedures and complying with legal regulations.
  • Updates job knowledge by participating in educational opportunities and reading professional publications.
  • Serves and protects the practice by adhering to professional standards; facility policies and procedures; and federal, state, and local requirements.
  • Enhances practice reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
  • Schedules follow-up appointments as requested by providers.

Qualifications/Skills:

  • Supply management
  • Verbal communication
  • Infection control
  • Creating a safe, effective environment
  • Organization
  • Scheduling
  • Professionalism
  • Customer focus
  • Confidentiality
  • Confidentiality
  • Bedside manner
  • Medical teamwork

Education, Experience, and Licensing Requirements:

  • Certified Clinical Medical Assistant (CCMA)
  • Bachelor’s degree preferred
  • 1+ years in a medical office
  • Experience with EMR (electronic medical records), medical terminology
  • Previous experience in specific medical field preferred
  • Excellent interpersonal skills
  • Ability to communicate clearly and effectively with patients and other external parties in a courteous and friendly manner at all times
  • Must be detail-oriented and highly organized
  • Firm grasp on medical practices, administrative processes, and organizational policies
  • Knowledge of patient care and examination procedures
  • Must be able to maintain confidentiality at all times

Medical Scribe

Job Responsibilities:

  • Prepares and assembles medical record documentation/charts for physician(s).
  • Enter the patient room (virtually) with the physician during patient visit to capture and transcribe medical record documentation utilizing electronic medical record applications.
  • Ensures medical record compliance by self-documentation attestation.
  • Updates patient history, physical exam, and other pertinent health information in the patient.
  • Prepares and sends all documentation to physician for review and approval via authentication of detailed data entry and facility-specific procedures.
  • Complies with practice rules and medical facility policies, including those relating to HIPAA and Joint Commission.
  • Performs other clerical duties and tasks to improve provider productivity and clinic workflow as assigned.

Qualifications/Skills:

  • Administrative writing skills
  • Reporting skills
  • Organizational skills
  • Record-keeping
  • Microsoft Office skills
  • Professionalism, confidentiality, and organization
  • Typing
  • Verbal Communication

Education, Experience, and Licensing Requirements:

  • High school diploma, GED, or equivalent
  • Bachelor’s degree with pre-health career track preferred
  • Knowledge of medical terminology and human anatomy a plus
  • Skilled in operating various medical record software and hardware, word-processing, and database software programs
  • Typing speed – minimum of 60 WPM preferred

Eligibility Specialist

Job Description:

  • Verify eligibility and benefits for all patients with appointments including the deductible and co-pay information prior to the appointment time. Make comments in each account in the EMR.
  • Reviews appointment list to ensure that all requisite documents and monies have been received and documented.
  • Cancel or reschedule patients based on insurance information, outstanding monies/documents as needed
  • Verify demographic information on new patients and any patients with changes.
  • Communicates any discrepancy in requirements with patients via all available channels.
  • Cover for Virtual Receptionist as needed.
  • Other duties as assigned

Qualifications:

  • Bilingual (Not Mandatory)
  • High school diploma or equivalent.
  • One year minimum experience in eligibility and benefits from physician
  • Excellent customer service and communication skills.
  • Ability to work as a team member.
  • Manage multiple tasks simultaneously.
  • Highly motivated and organized.
  • Empathetic with patients’ needs and concerns.
  • Excel under pressure
  • Attention to detail.

Coding Specialist

Job Summary:

The Collections Specialist will be responsible for managing accounts receivable, ensuring timely collection of outstanding debts, and maintaining positive relationships with clients. The ideal candidate will have strong communication skills, a problem-solving mindset, and a thorough understanding of collections processes.

Responsibilities:

  • Manage and monitor accounts receivable to ensure timely collection of outstanding invoices.
  • Contact clients via phone, email, or mail to follow up on overdue accounts and negotiate payment plans.
  • Maintain accurate records of all collection activities, including communications and payment arrangements.
  • Collaborate with internal teams to resolve billing discrepancies and address client inquiries.
  • Prepare and send collection letters and statements as needed.
  • Conduct regular account reviews to identify high-risk accounts and implement appropriate collection strategies.
  • Stay updated on industry regulations and company policies regarding collections and debt recovery.
  • Analyze financial reports and account statuses to provide insights and recommendations for improving collection processes.
  • Participate in team meetings to discuss progress, challenges, and strategies for improving collections.

Knowledge and Experience:

  • High school diploma or equivalent; degree in finance, accounting, or business administration is preferred.
  • Previous experience in collections, accounts receivable, or a related financial role is highly desirable.
  • Strong knowledge of collections laws and regulations.
  • Proficient in using accounting software and Microsoft Office Suite, particularly Excel.
  • Excellent verbal and written communication skills, with a focus on customer service.
  • Strong analytical and problem-solving skills, with attention to detail.
  • Ability to handle difficult conversations with professionalism and tact.
  • Ability to work independently and as part of a team in a fast-paced environment.

Education and Experience:

  • High school diploma, GED, or equivalent.
  • A university/college degree, or experience medical records, claims or billing areas is an asset.
  • Previous medical office experience preferred. (preferably more than 3 years).

Surgery Scheduler

Job Summary:

The Surgery Scheduler will be responsible for coordinating surgical procedures, ensuring seamless communication between patients, surgeons, and medical staff. The ideal candidate will have exceptional multitasking abilities, strong interpersonal skills, and a passion for delivering excellent patient care.

RESPONSIBILITIES:

  • Schedule surgical procedures by coordinating with surgeons, patients, and operating room staff.
  • Maintain an organized calendar of surgeries, ensuring efficient use of surgical resources and time.
  • Communicate with patients to confirm appointments, provide pre-operative instructions, and answer any questions related to their surgery.
  • Verify insurance coverage and obtain necessary pre-authorizations for procedures.
  • Collaborate with medical staff to prepare for surgeries, including managing any necessary documentation and patient records.
  • Update and maintain electronic health records (EHR) to reflect scheduling changes and patient information accurately.
  • Monitor and manage surgery cancellations and rescheduling to optimize scheduling efficiency.
  • Provide exceptional customer service, addressing patient concerns and ensuring a positive experience throughout the surgical process.
  • Assist in tracking and reporting surgical outcomes and patient feedback for continuous improvement.
  • Stay current on surgical scheduling policies and procedures, ensuring compliance with regulatory standards.

Knowledge and Experience:

  • High school diploma or equivalent; additional education in healthcare administration or related field preferred.
  • Previous experience in a healthcare setting, particularly in scheduling or administrative roles, is highly desirable.
  • Familiarity with surgical procedures, medical terminology, and insurance processes is a plus.
  • Proficient in using electronic health record (EHR) systems and scheduling software.
  • Strong organizational skills and the ability to manage multiple tasks in a fast-paced environment.
  • Excellent verbal and written communication skills, with a customer-focused approach.
  • Ability to work collaboratively in a team-oriented environment.
  • Problem-solving skills and the ability to adapt to changing priorities.

Coding Specialist

Job Summary:

The Collections Specialist will be responsible for managing accounts receivable, ensuring timely collection of outstanding debts, and maintaining positive relationships with clients. The ideal candidate will have strong communication skills, a problem-solving mindset, and a thorough understanding of collections processes.

Responsibilities:

  • Manage and monitor accounts receivable to ensure timely collection of outstanding invoices.
  • Contact clients via phone, email, or mail to follow up on overdue accounts and negotiate payment plans.
  • Maintain accurate records of all collection activities, including communications and payment arrangements.
  • Collaborate with internal teams to resolve billing discrepancies and address client inquiries.
  • Prepare and send collection letters and statements as needed.
  • Conduct regular account reviews to identify high-risk accounts and implement appropriate collection strategies.
  • Stay updated on industry regulations and company policies regarding collections and debt recovery.
  • Analyze financial reports and account statuses to provide insights and recommendations for improving collection processes.
  • Participate in team meetings to discuss progress, challenges, and strategies for improving collections.

Knowledge and Experience:

  • High school diploma or equivalent; degree in finance, accounting, or business administration is preferred.
  • Previous experience in collections, accounts receivable, or a related financial role is highly desirable.
  • Strong knowledge of collections laws and regulations.
  • Proficient in using accounting software and Microsoft Office Suite, particularly Excel.
  • Excellent verbal and written communication skills, with a focus on customer service.
  • Strong analytical and problem-solving skills, with attention to detail.
  • Ability to handle difficult conversations with professionalism and tact.
  • Ability to work independently and as part of a team in a fast-paced environment.

Education and Experience:

  • High school diploma, GED, or equivalent.
  • A university/college degree, or experience medical records, claims or billing areas is an asset.
  • Previous medical office experience preferred. (preferably more than 3 years).

Payment Reconciliation Specialist

Overview:

The Payment Reconciliation Specialist will be responsible for ensuring the accuracy of financial transactions by reconciling payments received against invoices, maintaining accurate records, and resolving discrepancies. If you have a keen eye for detail and a passion for financial accuracy is valued.

RESPONSIBILITIES:

  • Perform daily reconciliation of payments received, ensuring all transactions are accurately recorded in the accounting system.
  • Match payments to corresponding invoices and investigate discrepancies to ensure timely resolution.
  • Prepare and maintain detailed reports on payment activities, including outstanding balances and reconciliation status.
  • Collaborate with internal teams, such as accounts receivable and billing, to resolve payment issues and improve processes.
  • Monitor and analyze discrepancies in payment records and develop solutions to prevent future occurrences.
  • Assist in month-end and year-end closing processes by providing accurate reconciliation data and supporting documentation.
  • Ensure compliance with financial policies and procedures while maintaining confidentiality of sensitive financial information.
  • Stay informed on industry best practices and recommend improvements to the reconciliation process as needed.

Knowledge and Experience:

  • High school diploma or equivalent; a degree in finance, accounting, or a related field is preferred.
  • Previous experience in payment reconciliation, accounts receivable, or a similar financial role is highly desirable.
  • Strong understanding of accounting principles and financial transactions.
  • Proficient in using accounting software and Microsoft Office Suite, particularly Excel.
  • Excellent analytical and problem-solving skills, with a strong attention to detail.
  • Effective communication skills, both verbal and written, to collaborate with internal teams and resolve discrepancies.
  • Ability to manage time effectively and prioritize tasks in a fast-paced environment.
  • Strong organizational skills and a proactive approach to identifying and resolving issues.

Testimonials

MiBella Wellness

Their user-friendly platform made scheduling appointments and accessing medical records a breeze, while their staff provided exceptional customer service—always courteous, responsive, and attentive. The accuracy with which they handled my records and billing was impeccable, providing peace of mind throughout the process.

MiBella Wellness

The team was exceptionally professional, handling all my inquiries with promptness and clarity. Their meticulous attention to detail in managing billing and documentation gave me confidence that everything was in order.

MiBella Wellness

Their administrative services are both efficient and well-organized, making appointment scheduling and record management effortless. The customer support team was incredibly helpful, providing clear, prompt responses and a high level of professionalism. I was particularly impressed with their accuracy in handling my medical records and billing, which gave me great peace of mind.